Características epidemiológicas e óbitos de prematuros atendidos em hospital de referência para gestante de alto risco

Freitas, Brunnella Alcântara Chagas de; Sant’Ana, Luciana Ferreira da Rocha; Longo, Giana Zarbato; Siqueira-Batista, Rodrigo; Priore, Sílvia Eloíza; Franceschini, Sylvia do Carmo Castro

doi:10.1590/s0103-507x2012000400016

Cited by 8 publications

(17 citation statements)

References 38 publications

(65 reference statements)

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“…In a previous study with this population, Freitas et al 34 found a frequency of small for gestational age at birth of 11.3% using as reference Lubchenco's et al 35 curves, confirming the association between small for gestational age at birth and higher odds of death, which was corroborated by Larroque et al 36 However, if the data were revisited and the Fenton & Kim 9 curves were used, this prevalence would increase to 17.7%, which is important when considering the associations between small for gestational age at birth and the outcomes EUGR and death.…”

Section: Discussionmentioning

confidence: 85%

Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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Objective: To analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. Methods: This is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalenceratios . Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possible confounding factors. Results: The frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-for-gestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores of non-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p <0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p =0.010). Conclusion: Extrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-for-gestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem.

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Section: Discussionmentioning

confidence: 85%

Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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“…Observou-se uma predominância da macrorregião de Fortaleza com 56,25% dos casos (n=36), com a cidade de Fortaleza responsável pelo maior número de casos. 13 A macrorregião de Sobral não pontuou nenhum óbito no período, fato atribuído à presença foi de 24±6,2 anos. Destaca-se que pouco mais de 40% das genitoras eram adolescentes (<20 anos).…”

Section: Resultsunclassified

“…Pesquisa de Freitas e col. sobre óbito de prematuros no interior do Estado do Ceará (2012) considerou a gravidez na adolescência um problema de saúde pública devido às complicações obstétricas que repercutem na saúde materno-infantil, além dos problemas psicossociais e econômicos. 13,14 Neste grupo houve predomínio de primíparas 62,1% (n=36) e a média de paridade foi de 1,43 um fator de risco associado ao óbito neonatal (2,5 e 1,8 vezes maior respectivamente), devido à prematuridade e baixo peso como fatores associados. 11,12 A escolaridade média materna foi de 6,6 anos e mediana de 8 anos.…”

Section: Resultsunclassified

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Fatores relacionados ao óbito hospitalar neonatal<br>doi: 10.20513/2447-6595.2016v56n2p16-20

Silva

Gois²

2016

Rev. Med. UFC

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RESUMOOBJETIVO: Analisar os fatores relacionados aos óbitos em crianças menores de 28 dias de vida durante o ano de 2014 em um hospital pediátrico terciário. METODOLOGIA: Estudo observacional, transversal, analítico, retrospectivo e descritivo realizado no Hospital Infantil Albert Sabin/HIAS no período de janeiro a dezembro de 2014 (12 meses). Foram incluídos óbitos, independente de tempo de hospitalização, preenchimento de declaração de óbito ou submissão à necropsia. O banco de dados foi formatado usando o programa SPSS 13.0 for Windows e análises univariadas descritivas (frequência, média, mediana, desvio padrão). RESULTADOS: A amostra conta com registro de 64 óbitos, com discreto predomínio do sexo feminino (51,6%), idade média de admissão foi de 3,2±1 dias, 50% dos neonatos que foram a óbito pesavam menos de 2.500 gramas. Os principais motivos de referência foram prematuridade (28,5%) e dispneia (23,4%). Quanto à qualidade desse transporte 73,4% foram regulados e 58,7% não foram acompanhados por médicos. A causa básica de óbitos foi a prematuridade e causa imediata choque séptico. CONCLUSÃO: A baixa qualidade da assistência perinatal, o parto prematuro, o baixo peso e o transporte pós-natal inadequado são os grandes contribuintes das taxas de mortalidade neonatal, sobretudo antes do 7º dia de vida. Palavras-chave: Morte neonatal. Prematuridade. Recém-nascido de baixo peso. ABSTRACT OBJECTIVE: To analyze the factors related to deaths in children under 28 days old during the year of 2014 in a tertiary pediatric hospital. METHODS: observational, cross-sectional, analytical, a retrospective held at the Children's Hospital Albert Sabin/ HIAS from January to December 2014 (12 months). Deaths were included, regardless of length of hospital stay, death DeclarationWindows and descriptive univariate analysis (frequency, mean, median, standard deviation). RESULTS: The sample has a record of 64 deaths, with a slight predominance of females (51.6%), average age of admission was 3.2 ± 1 days, 50% of neonates who died weighed less than 2,500 grams. The main reference reasons were prematurity (28.5%) and dyspnea (23.4%). As for the quality of such transport 73.4% were regulated and 58.7% were not accompanied by doctors. The basic cause of death was prematurity and immediate cause septic shock. CONCLUSION: The low quality of perinatal care, premature delivery, low birth weight and inadequate postnatal transport are the major contributors to neonatal mortality rates, especially before the 7th day of life.

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“…No presente estudo houve um maior número de admissões em recém-nascidos do gênero masculino, resultado semelhante foi encontrado no estudo de Lima et al, (2015), Souza et al, (2013) (FREITAS et. al., 2012;ZORZI, et al, 2012).…”

Section: Discussionunclassified